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- ItemAdherence to anti-hypertensive medication regimens among patients attending the G.P.H.A. Hospital in Takoradi - Ghana.(2006-08-08) Jambedu, Haruna AhmedBackground: Adherence is the extent to which a person’s medication-taking behaviour coincides with the healthcare providers’ medical advice. It includes both dosing regularity and timing of intake. Many physicians face the problem of non-adherence among their hypertensive patient population. During the first year of treatment 16 – 50% of patients stop taking their high blood pressure medications. Overall, it is estimated that only about 30 – 50% of patients with hypertension adhere precisely to their hypertension medication regimens. Adherence is important in the treatment of hypertension Objectives: The objective of this study was to assess the extent of non-adherence to hypertensive medication regimen in G.P.H.A. Hospital, Takoradi. The reasons for non-adherence in the study were also evaluated. Methods: A prospective study of 150 hypertensive patients on medication for at least 6 months, who reported at the OPD of this hospital, was carried out. The Morisky questionnaire was administered to the patients and reasons for non-adherence sought. Pregnancy related hypertensive patients were excluded in this study. Results: The study revealed that total adherence to anti-hypertensive medications regimens was 19.3% and partial or medium adherence was 49.3%. Hence the adherence rates (i.e. those who took their medications ≥ 75%) to anti-hypertensive medicines in the institution was 68.6% and the non-adherence rate was 31.4%. The major reasons for non-adherence were forgetfulness (45.4%) by the patient to take medications on time or missed doses and side effects of the medications (20.8%). Finance (10.4% was also a problem for the paying patients who have to make up-front payment to re-fill their medicines. Conclusion: The prevalence of adherence among hypertensive patients in this health facility was 68.6%. Thus, indicating the need for adherence counselling.
- ItemEvaluation Of Intermittent Preventive Treatment Of Malaria In Pregnancy (IPT) Implementation In The Kumasi Ashanti Region, Ghana.(2008-07-12) Priscilla Anima, SiawMalaria is a serious public health problem that affects both the young and old especially the vulnerable ones being children and pregnant women. Again, prevention of the serious health impact associated with malaria during pregnancy represents one of the pending public health goals of WHO policy as well as the Ghana Roll Back Preventive Treatment (IPT) is a preventive measure adopted for the prevention of malaria in pregnancy. Objective The primary objective of this study is to assess the IPT of malaria in pregnancy in relation to the processes, outcomes and impact of the policy in the Kumasi metropolis of the Ashanti Region – Ghana. Methodology The study was a descriptive qualitative and quantitative cross sectional study supported with health facilities records review. The data were collected in August 2008 using household interviews during which 400 respondents (280 pregnant women and 120 nursing mothers who have delivered between January and June, 2008) were sampled using a EPI cluster sampling technique were interviewed. Seventy (70) midwives and 22 key informants at post in some selected health facility within the Manhyia North, the Subin and the Bantama Sub-metros were in-depth interviewed with close-ended questionnaire. Forty-seven (47) health facilities which offer maternity services were also surveyed with the aid of a checklist. A review of the Kumasi Metropolis health records was also conducted. Seven descriptive processes, out come and impact indicators were used in the study. These included: training and KAP of midwives, ANC utilization in the metropolis, the KAP of pregnant mothers and midwives towards malaria in pregnancy, IPT coverage, management supply of SP, the incidence of adverse effects of SP in pregnant mothers on IPT and the incidence of LBW as well as maternal aneamia.
- ItemAssessing the dropout rate of the expanded programme on immunisation in Asutifi District.(2008-07-12) Akutteh, Hanson MensahThe induction of an immune response to infectious disease by vaccination has become a widely applied and acceptable public health intervention. For immunisation to be effective as a long-term global childhood disease control strategy, it is essential that parents continue to present their children for vaccination. A recent study in assessing the dropout rate of immunization has shown that, immunization coverage in Asutifi District has been high with percentage of fully vaccinated children ranging between 95% in the district and 90% to 97% in the sub-districts. There is an account of high dropout rate of eligible children receiving the vaccines in the sub-district above the National and WHO, recommended level of dropout rate less than 10% (WHO, 2005). The aim of the study was to determine the dropout rate of the Expanded Program on Immunization to assess the ability of the service to hold on to the number of children who started the vaccination. A descriptive cross-sectional survey among a representative sample of 300 children between the ages of 12-23 months from households with varying socio-economic status from both urban and rural sub-districts was done to illicit information on the immunization coverage. Approximately 95% of children under the age of two had been completely vaccinated. Averagely about 40% of eligible children in the district had timely received vaccines during EPI programme. Seventy seven percent of children receive their vaccination at the outreach post. The vaccination schedule showed that 4.4% who started BCG vaccination dropped out as at the time of receiving measles vaccine. The dropout rate for DPT1 and DPT 3 was 0.67%. More than 62% of mothers do not present their children for vaccination because they are busy with their economic activities and 31.25% of household are unaware of the need to return for subsequent doses. These shortcomings are affecting the sustainability of routine immunisation programmes and are promoting the growth of a large number of partially immunised children. To protect the continued operations and to enhance the coverage of routine vaccination programmes, it is important that the dropout rate and these difficulties be addressed. The dropout rates for children in the sub-district are between 5% and 10% signifying differences in how each sub-district is able to hold the number of eligible children who were targeted for vaccination. Generally the dropout rate indicates that the efficiency of the service delivered during EPI programme in the sub-district differ from one sub-district to another. The difference that exist in the dropouts within the sub-districts demonstrate a service delivery gap and suggest that greater efforts are required by government and the district health management team to rethink of resource allocation and strengthening processes to improve immunization coverage among rural poor.
- ItemAcceptance of HIV Counselling & Testing Among Pregnant Women in the Kumasi Metropolis(2008-07-13) Sakyi, Kwofie GabrielIn Ghana, as in most parts of Africa, south of the Sahara, HIV/AIDS account for a lot of mortality and morbidity in children. Children born to infected mothers acquire infection and progress to clinical diseases. This mother-to-child-Transmission (MTCT), accounts for most of the cases in children less than 15 years. To help address this problem, the Ghana National Policy on HIV/AIDS and STIs has come out with strategies that include the use of routine Counseling and Testing (CT) as a tool for the prevention of MTCT (PMTCT). The main objective of this study was to determine the level of acceptance of this routine HIV CT, as well as factors associated with acceptance among pregnant women in Kumasi Metropolis. The study was a descriptive cross-sectional type, with structured questionnaire as the data collection tool served on 200 pregnant women attending Antenatal Clinic (ANC) in the Kumasi Metropolis. The sampling frame was pregnant women attending ANC at the three hospitals in the metropolis. The 200 ANC attendants were selected by a systematic random sampling technique. Findings include a high level of acceptance, with 87.5% of respondents accepting to undergo HIV testing either before or after counseling. The effects of socio-demographic characteristics on acceptance of HIV CT were not statistically significant. The knowledge level of pregnant women on HIV/AIDS and Prevention of mother to Child transmission (PMTCT) significantly affected HIV CT acceptance (p = 0.000): Those with adequate knowledge levels were twenty four times more likely to accept HIV CT than those with inadequate knowledge levels. Seeking Spousal permission did not significantly affect acceptance (p= 0.86). However, spousal involvement significantly encouraged HIV CT (p = 0.04) Given the high, level of acceptance which is consistent with high acceptance levels in some African studies, the existing strategy of routine HIV CT, as a tool for PMTCT of HIV, should be sustained, and if possible improved upon.
- ItemAntimicrobial and wound healing activities of Clerodendron Splendens G. Don(2008-08-09) Kisseih, EmeliaClerodendron splendens G. Don (Fam. Verbanaceae) is a well known plant in Ghanaian folklore medicine for treating various skin infections and in wound healing. Based on its traditional use, this plant was evaluated for its antimicrobial, wound healing and antioxidant properties. Juice expressed from the fresh leaves and ethanol, acetone and chloroform extracts of the dried leaves, stem and root, all exhibited various degrees of antimicrobial activity against the test microorganisms: Pseudomonas aeruginosa (NCIMB1042), Escherichia coli (NCTC9002), Staphylococcus aureus(NCTC4163), Bacillus subtilis (NCTC10073), Proteus mirabilis (NCTC13376), Klebsiella pneumonia (NCTC5055) and Candida albicans (NCTC3255), with minimum inhibitory concentrations ranging from 0.15 to 7mg/ml. The time-kill kinetics studies conducted suggested microbistatic activity of the various extracts against these test microorganisms employed. The extracts (fresh juice, 3, 30, 300 and 1000 mg/ml) were topically applied twelve hourly to excision wounds created on the back of Sprague Dawley rats in groups of seven. Two more groups serving as the controls were also treated with 1%w/w Silver sulphurdiazine cream and the vehicle (normal saline + tween80). The extracts showed faster rate of wound contraction in the first 5 days than the controls. Higher breaking strengths were recorded, especially in the 300mg/ml treated group, suggesting the possibility of higher collagen content of the repaired tissues than in the control groups. C. splendens also exhibited antioxidant activity in the DPPH (1-diphenyl-2- picrylhydrazyl) radical scavenging assay with IC50 value of 5.61± 0.04 mg/ml. Thus this study provides a scientific rationale for the traditional use of this plant in the management of wounds and other infectious conditions.
- ItemStudies of Entomological Parameters and Perception of Malaria Transmission on the Kwame Nkrumah University of Science and Technology campus, in the Ashanti Region of Ghana(2009) Coleman, SylvesterMalaria is a major public health problem in Ghana. Estimations are that 3.5 million people contract malaria every year. In order to develop effective control interventions targeted at reducing the malaria burden in any setting, it is important to understand the major factors that affect transmission and sustenance of the disease. The study was conducted on the Kwame Nkrumah University of Science and Technology (KNUST) campus to determine the vector species present and their roles in malaria transmission, map out areas of high malaria risk using GIS, and seek the perception of inhabitants of the KNUST campus on malaria. Monthly mosquito sampling surveys revealed the existence of varied larval habitat types within the area, mostly characterised by clear or turbid shallow and sunlit conditions, with the greatest larval density contributed, mainly by vegetable gardens and irrigated farmlands. A. gambiae Giles complex, A. funestus Giles complex and A. zieamanni Grunberg were the three Anopheles species that were identified from 843 Anopheles spp that were caught from all night human landing collection during the survey. Of the 3 species A. gambiae proved to be the main species, with a sporozoite index of 1.01% and 0.57% for the dry and rainy seasons respectively. An average entomological inoculation rate (EIR) of 0.059 infective b/m/n and an annual EIR of 22 ib/m/yr were estimated. The faculty area was identified as area with the highest malaria risk, with respect to entomological parameters that were measured during the period. A KAP survey revealed that respondents had high malaria knowledge with 97.4% of respondents relating malaria to mosquito bites. Some respondents on the other hand also thought that eating too much oil and long exposure to sunshine caused malaria. However, high knowledge of malaria did not necessarily result in correct attitudes and practices. This study reveals that though malaria transmission appeared low on the KNUST campus, misconceptions of some inhabitants on malaria transmission coupled with the high abundance of Anopheles gambiae Giles complex, on the KNUST campus could result in high levels of transmission if an infectious gametocyte pool comes into play. The study also provides a GIS based malaria information, which needs to be considered and integrated into the design and implementation of future malaria control interventions on the KNUST campus and its immediate surroundings. Educational programs aimed at increasing awareness on the correct attitudes and practices towards malaria transmission could promote community participation for effective malaria control in the study area.
- ItemThe Role of Orientation on Labour Turnover. (A Case of Ghana Health Service)(2009-07-13) Adu- Gyamfi, AugustineGlobal competition, environmental flux and technological advancement present challenges to organizations. It is for these reasons that organizations need to orientate its employees to equip them with current skills and knowledge. This study was conducted to find out the role of orientation on labour turnover in the Ghana Health Service. The methodology that was used in collecting the research data was simple random sampling base on the face to face interviews. The results indicated that the organization needs an orientation for its new and old staff. It also pointed out that an orientation practice in the organization is facing many problems. Moreover, certain factors also militate against efficient orientation practices in the Ghana Health Service. Based on the findings, a number of recommendations have been made among which is the need for Ghana Health Service to adopt a more comprehensive approach to orientation. Also Ghana Health Service should provide information in a way that can be absorbed and retained. In the same vain, to use orientation program to develop a team environment and to ensure that orientation is effectively and efficiently conducted and managed for the realization of the goals and objectives of Ghana Health Service.
- ItemControlling malaria in pregnancy: investigating the factors that influence the uptake of intermittent preventive treatment services in the Nzema-east district, Ghana(2009-08-05) Acquah, Augustine Adolf KwameTo help reduce the burden of malaria in pregnancy, the Ministry of Health introduced the intermittent preventive treatment (IPT) programme with Sulfadoxine-pyrimethamine (SP) for pregnant women as a national policy in 1999. Nine hundred women from fifty communities in the Nzema-East District were sampled in a cross-sectional household survey in August, 2008 in this study to determine the factors that influence the uptake of IPT services. Majority of the women, 95.1%; CI [93.6 – 96.4] had an encounter with the ANC during their last pregnancies. More than half, 52%; CI [47.7 – 54.3] of the women had their first ANC encounter in the first trimester, and 57.3%; CI [53.8 – 60.2] made four or more visits to the ANC before delivery. Even though ANC attendance was high, only 47.2%; CI [43.1 - 50.8] of the 641 women who took SP as IPT had three doses. Women who lacked formal education were more likely not to have complete IPT (OR 1.5; CI 1.23 – 1.69). Employment, marital status, educational level, number of ANC visits and gestational age at first ANC visit were significant predictors of IPT uptake (p < 0.05). Education on the benefits of IPT for the woman and the unborn child, and the negative consequences of malaria in pregnancy should be emphasised at ANC sessions. There should be conscious effects to ensure continuous supply of SP to health facilities. Community health workers should be trained to administer SP at the community level.
- ItemComplementary Feeding Practices And Nutrition Status Of Young Children 06-23 months of Age in the Kassena-Nankana District, Upper East Region, Ghana(2010-07-12) Martin Nyaaba, AdokiyaMalnutrition is responsible globally for 60.0% of deaths among children under 5 years and is often attributed to suboptimal feeding practices. The objective was to assess complementary feeding practices among young children 06-23 months of age and their nutritional status. Hypothesis of the study was to identify if there is an association between early introduction of complementary foods (before 6 months of age) and the nutritional status of children 06-23 months of age in the Kassena-Nankana District, Ghana. A cross sectional household study was conducted in the Kassena-Nankana District, 379 children and mothers/caregivers were selected using a multistage sampling method. Complementary feeding practices of young children and nutritional status of both mother/caregiver and child was assessed. The study also assessed mothers’ knowledge on complementary feeding. From the study, 61.2% of the children were timely introduced to complementary foods (6 months of age) and 96.3% of the children were still breastfeeding. The prevalence of child undernutrition among the children was as follows: stunting (HAZ <-2 z scores) was 15.6%, underweight (WAZ <-2 z scores) 15.3% and wasting (WHZ <-2 z scores) 8.7%. Prevalence of maternal malnutrition was 10.3% (BMI<18.5kg/m2), overweight was 12.4% (BMI>18.5-≤30.0-kg/m2) and obese was 2.4% (BMI>30.0kg/m2). This is a measure of the double burden of malnutrition in the district. There was no association between early introduction of complementary foods before six months and child undernutrition based on univariate analysis (unadjusted). There was no statistically significance when the children were compared using complementary foods introduction time and child undernutrition: stunting was (<6 months of age: OR=0.70, 95%CI=0.31-1.59, P=0.400), underweight (<6 months of age: OR=1.04, 95%CI=0.48-2.23, P=0.920), and wasting (<6 months of age: OR=0.65, 95%CI=0.21-1.96, P=0.442) of infants and young children. A significant association (adjusted odds ratio) was found between stunting and age (6-8 months, 9-11 months and 18-23 months), primary level of maternal education, female sex, whilst underweight was associated with age (6-8 months, 9-11 months and 18-23 months), divorced/separated marital status, Nankam/Frafra tribe, primary level of maternal education, and female sex. Wasting was associated with only female sex. There was high frequency (38.8%) of inappropriate complementary feeding practices in the district. Though there was no association of child malnutrition and early introduction of complementary foods this relation does exist and could be found in a similar survey.
- ItemDevelopment Of A Reverse-Phase Hplc Method for the Quantification of Cryptolepine in the Dry Roots of Cryptolepis Sanguinolenta .(2010-07-13) Ofori, EdwardCryptolepis sanguinolenta is a slender, thin-stemmed climbing shrub with orange-coloured juice in the cut stem which is distributed throughout the west coast of Africa. The aqueous root extract is a popular antimalarial in West African ethnomedicine. It is commonly known in Ghana as Ghana quinine or “Nibima” (Twi language). The dry roots of Cryptolepis sanguinolenta were obtained from Center for Scientific Research into Plant Medicine (CSRPM), Akropong-Mampong. Roots were authenticated by comparing with herbarium sample at the Department of Pharmacognosy, KNUST. The major alkaloid in the roots of Cryptolepis sanguinolenta, cryptolepine, was isolated by means of gravity column chromatography of the total alkaloidal extract followed by preparative TLC (Mobile phase: ethylacetate:methanol:ammonia (35%) 80:15:5) using a reference cryptolepine(CLP-R) sample. The authenticity of the isolated cryptolepine was confirmed by determining the UV, Infrared, 13C and 1H Nuclear Magnetic Resonance (NMR) and mass spectrometric data and the assignments were in agreement with those reported by by Grellier et al., (1996) and Dwuma-Badu, et al., (1978). As a step towards efforts to standardize and to ensure quality in herbal preparations containing extracts of the roots of Cryptolepis sanguinolenta, a simple reverse-phase HPLC method with UV detection was developed and validated to quantify the levels of cryptolepine in the roots of the Cryptolepis plant. An isocratic elution of extractable cryptolepine in methanolic extract of dry roots of Cryptolepis was performed using methanol: water (90:9) modified with trifluoroacetic acid(TFA,98%) to a pH of 2.4 as mobile phase set at flow rate of 1ml/min on a Hichrom Zorbax C8 Column (5micron 15cm×4.6mm id) and cryptolepine monitored at 366nm. The average retention time of cryptolepine was found to be 2.723±0.069 min(n=8). The method developed was found to be precise since the intra-day and inter-day precision were <2% RSD in the concentration range of 1.02μg/ml-10.2μg/ml. Since the coefficient of correlation(r2) of 0.9976 for the regression line of peak area(y) against % concentration of cryptolepine(x) was greater than 0.995, the method was said to be linear in the concentration range. The method was also found to be robust since deliberate alteration of pH, flow rate and wavelength of detection in the range of 2.4±0.2units , 1±0.3ml/min and 366±2nm respectively did not affect the precision of the method. Hence, it could also be inferred that the method was accurate. The Limit of detection(LOD) and Limit of Quantitation(LOQ) of the method were found to be 0.574μg/ml and 1.740μg/ml respectively. The developed method was used to determine the percentage content of extractable cryptolepine in the roots of the Cryptolepis plant and it was found to be 2.763±0.185% w/w (n=9). This quantity of cryptolepine is the highest reported so far in the roots of the Cryptolepis plant.
- ItemDevelopment of a Reverse-Phase Hplc Method for the Quantification of Cryptolepine in the Dry Roots of Cryptolepis Sanguinolenta(2010-07-15) Ofori, EdwardCryptolepis sanguinolenta is a slender, thin-stemmed climbing shrub with orange-coloured juice in the cut stem which is distributed throughout the west coast of Africa. The aqueous root extract is a popular antimalarial in West African ethnomedicine. It is commonly known in Ghana as Ghana quinine or “Nibima” (Twi language). The dry roots of Cryptolepis sanguinolenta were obtained from Center for Scientific Research into Plant Medicine (CSRPM), Akropong-Mampong. Roots were authenticated by comparing with herbarium sample at the Department of Pharmacognosy, KNUST. The major alkaloid in the roots of Cryptolepis sanguinolenta, cryptolepine, was isolated by means of gravity column chromatography of the total alkaloidal extract followed by preparative TLC (Mobile phase: ethylacetate:methanol:ammonia (35%) 80:15:5) using a reference cryptolepine(CLP-R) sample. The authenticity of the isolated cryptolepine was confirmed by determining the UV, Infrared, 13C and 1H Nuclear Magnetic Resonance (NMR) and mass spectrometric data and the assignments were in agreement with those reported by by Grellier et al., (1996) and Dwuma-Badu, et al., (1978). As a step towards efforts to standardize and to ensure quality in herbal preparations containing extracts of the roots of Cryptolepis sanguinolenta, a simple reverse-phase HPLC method with UV detection was developed and validated to quantify the levels of cryptolepine in the roots of the Cryptolepis plant. An isocratic elution of extractable cryptolepine in methanolic extract of dry roots of Cryptolepis was performed using methanol: water (90:9) modified with trifluoroacetic acid(TFA,98%) to a pH of 2.4 as mobile phase set at flow rate of 1ml/min on a Hichrom Zorbax C8 Column (5micron 15cm×4.6mm id) and cryptolepine monitored at 366nm. The average retention time of cryptolepine was found to be 2.723±0.069 min(n=8). The method developed was found to be precise since the intra-day and inter-day precision were <2% RSD in the concentration range of 1.02μg/ml-10.2μg/ml. Since the coefficient of correlation(r2) of 0.9976 for the regression line of peak area(y) against % v concentration of cryptolepine(x) was greater than 0.995, the method was said to be linear in the concentration range. The method was also found to be robust since deliberate alteration of pH, flow rate and wavelength of detection in the range of 2.4±0.2units , 1±0.3ml/min and 366±2nm respectively did not affect the precision of the method. Hence, it could also be inferred that the method was accurate. The Limit of detection(LOD) and Limit of Quantitation(LOQ) of the method were found to be 0.574μg/ml and 1.740μg/ml respectively. The developed method was used to determine the percentage content of extractable cryptolepine in the roots of the Cryptolepis plant and it was found to be 2.763±0.185% w/w (n=9). This quantity of cryptolepine is the highest reported so far in the roots of the Cryptolepis plant.
- ItemEvaluation of the Level of Adherence to the Antimalarial Drug Policy by Prescribers in the treatment of Malaria in Child Health Directorate at Komfo Anokye Teaching Hospital.(2010-08-11) Attakorah, JosephThe medicines recommended in the National Drug Policy that was adopted in 2005 for uncomplicated malaria was Artesunate Amodiaquine and that for complicated malaria was Quinine. The aim of this study was to determine the level of adherence by the prescribers at the Child Health Directorate of Komfo Anokye Teaching Hospital (KATH) to the policy for the treatment of malaria. METHOD: The study design was retrospective, covering a six month period from August 2008 to January 2009. Five hundred paediatric patients aged one month to 14 years who contracted malaria and received treatment at the Child Health Directorate, of KATH was evaluated. KEY FINDINGS: The ages of the patients ranged from 0.08years (one month) to fourteen years. Sixty percent of the cases were children below five years. Most of the malaria victims were children below five years. The most prescribed anti-malaria drugs for the management of uncomplicated and complicated malaria were Amodiaquine plus Artesunate (90.5%) and Quinine (99.03%) respectively. The mean length of hospital stay for survivors was five days and the percentage mortality was 0.3% (n=1). The dosage form mostly prescribed for the period was syrup, constituting 68.9% followed by injectables (18.1%). The rest were tablets (10.6%) and suppositories (2.4%) CONCLUSION: the main anti-malarial prescribed for the management of uncomplicated and complicated malaria were Artesunate plus Amodiaquine (90.5%) and Quinine (99.03%) respectively. The level of adherence by the prescribers at the Child Health Directorate of KATH to the anti-malaria drug policy was high. This might have accounted for the high treatment success and the low mortality rate achieved.
- ItemViral Agents in Children Presenting with Signs and Symptoms of Respiratory Infections in the Ashanti-Akyem North District of Ghana(2011-03-14) Annan, Augustina AngelinaRespiratory Infections (RIs) constitute one of the major causes of morbidity and mortality among the pediatric population of developing countries. When caused by viruses, their manifestations are very difficult to detect on clinical grounds and most importantly by conventional diagnostic methods. Whilst studies on the viral causes of RIs are well documented in developed countries, there exist scanty information on them in most developing countries. The main aim of this study was to optimize and establish molecular diagnostic systems which are able to simultaneously detect several pathogens per clinical sample for respiratory viral infections. The viral aetiology and determinants of respiratory viral infections in children were also evaluated. Three real time multiplex Polymerase Chain Reaction (m-RT-PCR) and five monoplex real-time polymerase chain reactions (RT-PCR) were optimized and established for the detection of twelve respiratory agents during the study. The three m-RT-PCRs included two duplexes for the simultaneous detection of respiratory syncytial virus and human metapneumovirus (RSV/hMPV), influenza A and B (influenza A/B) and a triplex for parainfluenza 1, 2 and 3 (PIV 1-3). The five monoplexes included three assays for Rhinoviruses (RhV), Enteroviruses (ENT), Adenoviruses (AdV) and two for non-viral agents Mycoplasma pneumoniae (MYC) and Chlamydophilia pneumoniae (CHL). Nasopharyngeal swabs were taken from children who presented with at least two signs and symptoms suggestive of respiratory infection to the out patient department of Agogo Presbyterian Hospital in the Asante Akim North district in the Ashanti Region of Ghana between February 2008 and March 2009. Also collected were their sociodemographic, socioeconomic and clinical data. A predictive algorithm for the viral causes of respiratory infection was then developed. A total of 1,191 children were enrolled in the study. The developed assays detected 476 pathogens in 429 (36.5%) children. RSV/hMPV was the most frequently detected pathogen in 154 (13.1%), RhV in 93 (7.9%), PIV 1-3 in 83 (7.1%) and influenza A/B in 68 (5.8%) of the children. Furthermore, AdV and ENT were detected in 40 (3.4%) and 29 (2.4%) respectively whilst MYC was found in 6 (0.5%) of the children. CHL was detected in only 1 (0.1%) child. More than one respiratory agent was detected in 47 (3.9%) of the study participants. Despite the differences in the symptoms presented, most viral agents could not be associated with specific clinical signs or symptoms. The risk for RVIs decreased steadily with increasing age (OR=0.57, 95% CI: 0.49-0.67, p<0.05) with the youngest children (up to 12 months) at highest risk (OR=0.87, 95% CI: 0.69-1.10). This was true for RSV/hMPV, PIV 1-3 and AdV (p<0.05). For influenza A/B, there was an increased risk with increasing age (p<0.05). With an overall male-to-female ratio of 1.2:1, gender (p=0.99), religion (p=0.89) and ethnicity (p=0.56) were not associated with RVIs. High temperature (37.6°C) was also a significant determinant for viral respiratory infections (p<0.05). With the exception of maternal age (p=0.02) and nutrition (p<0.05), none of the maternal factors studied turned out to be predictors of RVIs in the children. Similarly, apart from associations between accessibility to health facilities (p<0.05), none of the socioeconomic factors were determinants of RVIs. While RSV/hMPV and influenza viruses were detectable during the rainfall seasons, PIV, RhV, ENT and AdV were detected sporadically throughout the year. This study has defined the epidemiology of specific respiratory viruses and the clinical presentation of children with signs and symptoms of respiratory infection. With the advent of molecular diagnostic techniques such as multiplex RT-PCR, this study provides valuable information to clinicians and virologists confronted with children suffering from respiratory tract illnesses of viral etiology for possible understanding of the viral causes of these infections.
- ItemEffects of Trichilia monadelpha (Thonn.) J. J. De Wilde (MELIACEAE) Bark Extracts on Ulcerative Colitis, Colonic Microflora and Wound Healing in Wistar Rats(2011-06-28) Ayande, Patrick GeorgeTrichilia monadelpha (Thonn.) de Wilde, has been reported to have therapeutic effect against microbes, dysentery, dyspepsia, sores and ulcers. However, no scientific basis is established of such claims. Thus, this study sought to determine the effectiveness of Trichilia monadelpha bark extracts on surface wounds and ulcerative colitis as well as the extent to which it could displace colonic microflora. Generally, Wistar rats of comparable age and weight were housed 5 per cage in 6 groups for each experimental set-up. The excision wound healing and indomethacin/acetic-acid induced animal models of ulcerative colitis were employed in this study. All extracts for the treatment of ulcerative colitis were administered orally, while wound treatment was carried out with topical formulations. In the indomethacin-induced ulcerative colitis, colons of animals treated with the ethanolic extract revealed persistent mucosal ulceration in the disease control and 30 mg/kg but not the 100 mg/kg and 300 mg/kg dose groups. For the acetic acid-induced ulcerative colitis, the aqueous extract significantly restored mucosal integrity in the 100 mg/kg and 300 mg/kg dose treated groups relative to the ulcerated and oedematous mucosae of 30 mg/kg treated group, pointing to a marked response to treatment in a dose dependent fashion. The petroleum ether extract manifested crypt abscesses and globular mucosae in the 100 mg/kg and 300 mg/kg dose treated groups of acetic acid-induced colitic rats, while the ethyl acetate extract showed serrated, crypt and oedematous mucosae among the 100 mg/kg and 300 mg/kg dose groups, evident of persistent disease. The role of Trichilia on colonic microflora in colitic rats suggested a dose dependent activity. There was a 24%, 12% and 8% microbial infestation among animals of the 30 mg/kg, 100 mg/kg and 300 mg/kg treated groups relative to a 32% and 24% occurrence in disease and normal controls respectively. Therefore, Trichilia was found to be detrimental to colonic microflora. In the case of excision wounds, the aqueous extract of Trichilia showed appreciable rate of healing in the 3% and 10% treated groups but not in the 30% dose treated group. On the other hand, rate of wound healing was dose dependent and comparable to the standard treatment among the ethanolic extract treated groups. Most wounds had completely healed by day 13. But the petroleum ether extract showed a relatively poor rate of wound healing with sepsis resulting into chronic wounds. The rate of wound healing in the ethyl acetate extract group was extremely poor, registering 100% mortality in the 30% treated group, characteristic of ineffective treatment. An anti-oxidant assay established the presence of anti-oxidant properties in the aqueous, ethanolic, and ethyl acetate extracts but not the petroleum ether extract. In conclusion, the aqueous extract of Trichilia proved to have a strong anti-oxidant property and was highly effective in the treatment of ulcerative colitis but slightly effective in excision wounds, while the ethanolic extract had appreciable anti-oxidant property and was effective in the treatment of ulcerative colitis but highly effective in the healing of excision wounds. The petroleum ether and ethyl acetate extracts did not prove to be effective treatment options in both cases. Trichilia was also found to displace colonic microfloral balance and could be effective against infectious colitis.
- ItemPregnant Women and Alcohol Use in the Bosomtwe District of the Ashanti Region(2011-08-29) Adusi-Poku, YawThere are anecdotal claims that problem of alcohol ingestion exists among women in the reproductive years in the Bosomtwe district of the Ashanti Region but there is lack of data to support this. The principal objective of this study therefore was to validate these claims by the assessment of alcohol consumption among pregnant women attending antenatal clinics in the Bosomtwe District of the Ashanti Region. The study, a descriptive cross-sectional, was conducted in ten health facilities providing reproductive health care in the district in the months of July to October, 2010 with a sample size of 397 pregnant women. The main findings of the study were that 20.4% of pregnant women drank alcohol even though about three-quarters (78.0%) thought that alcohol had harmful effects in pregnancy. Fifty-seven percent (57.0%) of these (78.0%) did not actually know the possible harm that alcohol could cause on pregnancy. The most preferred drink was Akpeteshie, a locally manufactured distilled alcoholic beverage (36.4%), followed by Ginsing/Kasapreko/Pusher (27.3%). Study participants drank an average of ‘half-tot’ and ‘one-tot’ per a drinking session respectively. Logistic Regression analysis to identify the effects of some socio-demographic variables on alcohol consumption revealed that, Marital status and Religious affiliation were predictive of alcohol consumption, p< 0.10. It is recommended that the DHMT strengthens health education on alcohol at ANC and through the radio as well as the DHMT collaborating with the Ghana Health Service to embark on education of school pupils and students on the harmful effects of alcohol in pregnancy.
- ItemAntibiotic Resistance Patterns of Pseudomonas Aeruginosa and Escherichia Coli Isolates from Three Hospitals In Kumasi(2011-10) Duredoh, Freeman GeorgeNosocomial infections are worrying situations in health care delivery across the world. Every year, millions of people report of contracting one form of nosocomial infections which are difficult to treat due to the level of antibiotic resistance exhibited by these microorganisms. In this study, a total of 600 samples including swabs of door handles, benches, beds, and floors, and waste water from drainages were collected from Tafo, Kumasi-South, and Suntreso Hospitals all in the Kumasi Metropolis between January and June, 2010 and cultured. By morphological and biochemical reactions, 57 strains of Pseudomonas aeruginosa and 97 strains of Escherichia coli were isolated, identified and tested for their antibiotic sensitivities using the Kirby-Bauer agar disc diffusion assay against ampicillin (10μg), gentamicin (10μg), ceftriaxone (30μg), ciprofloxazole (5μg), and co-trimoxazole (25μg) on Mueller-Hinton agar. E. coli was present in all the samples while P. aeruginosa was mainly present in samples from the floor, beds, drainages and door handles. All the P. aeruginosa isolates and about 90% of the E. coli isolates were resistant to ampicillin. For gentamicin, 46% of the P. aeruginosa isolates exhibited resistance while 21% and 33% showed intermediate and sensitive responses respectively. For ciprofloxacin, 36.84% of these isolates were resistant while equal proportions (31.58%) exhibited intermediate and sensitive responses. About 40% of the P. aeruginosa isolates also showed intermediate response to ceftriaxone while 39% and 21% were respectively resistant and sensitive. For gentamicin, many of the resistant P. aeruginosa isolates (34.6%) were obtained from door handle samples while majority of the sensitive isolates (47.4%) came from drainage samples. In the case of ceftriaxone, high proportions of drainage isolates were resistant (45.5%). Almost equal proportions of the drainage sample isolates recorded the various activities to ciprofloxacin: 38.9% sensitive, 38.1% resistant and 33.3% intermediate isolates. The study has also shown that out of 52 E. coli isolates from hospital beddings, 53.85% were resistant to gentamicin, 25% to ceftriaxone and 61.5% to ciprofloxacin. Similarly, out of 21 P. aeruginosa isolates from drainage samples, 28.57% were resistant to gentamicin, 47.62% to ceftriaxone and 28.57% to ciprofloxacin. Out of 97 E. coli isolates, 78(80.41%) were resistant to at least three different classes of antibiotics while 32(56.14%) out of 57 P. aeruginosa isolates were also resistant to at least three different classes of the antibiotics. vii This study has therefore highlighted the presence of antibiotic resistant pathogens in our hospital environments including more especially, hospital beddings. It has also provided data on these resistant pathogens which will be useful in health care policy planning in Ghana and the sub-region at large.
- ItemSurrogate reference standards in quantitative high performance liquid chromatography; a case study of the analysis of Piroxicam Capsules and Metronidazole Tablets(2012) Owusu, Nicholas AmoahA simple, rapid, accurate and sensitive High Performance Liquid Chromatography (HPLC) method was developed for quantitative analysis of Piroxicam and Metronidazole in Piroxicam capsules and Metronidazole tablets using surrogate reference standards with UV detection. Metronidazole, Metformin and Ascorbic acid pure samples were used as surrogate reference standards for the analysis of Piroxicam. The chromatography parameters were stainless steel ODS C18 Phenomenex 250 x 4.6mm column particle size. The isocratic mobile phase was methanol:phosphate buffer pH 6.2 (50:50; v/v) at a flow rate of at 1.0 mLmin-1. The determinations were performed using UV-Vis detector set at 254 nm. Mean retention times (minutes) of 6.83±0.065, 4.07±0.058, 3.42±0.049 and 2.56±0.055 were recorded for Piroxicam, Metronidazole, Metformin and Ascorbic acid respectively. A constant, K, was determined for Piroxicam using each of the surrogate reference standards. The respective K values obtained when Metronidazole, Metformin and Ascorbic acid were used as surrogate reference standards were 1.9411± 0.004, 1.6200 ± 0.006 and 0.4569 ± 0.006. Ascorbic acid and Para aminophenol pure samples were used as surrogate reference standards for the analysis of Metronidazole. The chromatography parameters were stainless steel ODS C18 Phenomenex 250 x 4.6mm column particle size. The isocratic mobile phase was methanol:phosphate buffer pH 6.2 (50:50; v/v) at a flow rate of at 1.5 mLmin-1. The determinations were performed using UV-Vis detector set at 254 nm. Mean retention times (minutes) of 4.24±0.014, 1.80±0.012 and 2.82±0.015 were recorded for Metronidazole, Ascorbic acid and Para aminophenol respectively. A constant, K, was determined for Metronidazole using each of the surrogate reference standards. The respective K values obtained when Ascorbic acid and Para aminophenol were used as surrogate reference standards were 0.6763 ± 0.004 and 1.1229 ± 0.016. The results obtained when the v methods were used for the analysis of the Piroxicam capsules and Metronidazole tablets were comparable to standard methods of analysis stated in the BP and USP respectively. The method showed adequate precision, with a relative standard deviation (RSD) less than 2% in each case. The HPLC methods developed in this study showed specificity and selectivity with linearity in the working range and good precision and accuracy, making them very suitable for quantification of Piroxicam capsules and Metronidazole tablets.
- ItemWater quality deterioration in piped water and its effect on usage and customers’ perception: case study of Adum- Kumasi, Ghana(2012) Mohammed, UmarAssessment of drinking water quality is important for sustainable development. Safe water is the door way to health and health is the pre-requisite for progress, social equity and human dignity. A study on households’ drinking water quality in Western Accra of Ghana from the Weija head-works revealed that the supplied water at some locations did not meet the potable water quality standard. This being the case, the question then arises as to whether it is an isolated case, or that the situation may be recurring in other parts of the country. The main goal of this study was to determine the water quality deterioration in piped water and its effect on water usage and customers’ perception at Adum in the Kumasi Metropolis of the Republic of Ghana. The specific objective of the study were to determine the quality of the treated water at Barekese headworks, to determine the quality of water from the household taps in the selected study area and to investigate customer perception on the quality of water delivered and its effect on usage. Fifty (50) water samples were taken from the Barekese Headworks, Suame reservoir and households at Adum. The samples were analyzed for the following selected physicochemical and bacteriological parameters: pH, ammonia, residual chlorine, electrical conductivity, total dissolved solids, alkalinity, calcium hardness, magnesium hardness, total hardness, magnesium, calcium, total iron, manganese, nitrate-nitrogen, turbidity, temperature, Escherichia coli, salmonella and faecal coliform. Consumer perception survey was used to examine the consumers’ perception of the water quality and how it affects their usage of the supplied water. The study revealed that the mean concentrations of all of the investigated physicochemical parameters in the drinking water samples were within the permissible limits of the World Health Organization (WHO)/Ghana Standard Authority (GSA) drinking water quality guidelines. More than half of the water samples collected from the Barekese Headworks, Suame reservoir and households indicated minimal contamination by E.coli and other coliform especially. Many (86%) customers did not have problems with the taste of the water whilst 84% of the customers had no problem with the smell of the water supplied. Eighty (80%) of the customers were satisfied with the colour of the water. The major complaint (50%) was with the sediment content of the water which needs to be looked at. All the consumers complained about the quality of the water supplied immediately after interruption. Customers’ perception of the water taste, smell and colour affected their choice of the water for drinking. The consumers’ usage of the water for drinking was independent of the sediment content. Usage of the water for cooking among the respondents was not influenced by their perception about the aesthetic appearance of the water.
- ItemPurification, physicochemical and formulation properties of shea (Vitellaria Paradoxa) Gum.(2012-06-15) Oppong, Esther EshunThis study focused on the purification, physichochemical and formulation properties of Shea (vitellaria paradoxa) gum. The crude gum was purified and the yield obtained was 63.26%. Crude and purified Shea gums were evaluated for their physicochemical properties and were found to have satisfactory moisture content and insoluble matter. Atomic absorption spectrophotometric analysis of the gums showed that the crude gum had higher metallic ion and protein content than the purified gum which may be attributed to the purification process. The gums had relatively high levels of calcium, followed by magnesium, iron, zinc, potassuim and sodium. Different concentrations of the gum were analysed for their rheological properties and were found to exhibit pseudoplastic flow.The binding property of Shea gum was compared to that of acacia, a standard binding agent. The flow properties of the granules were evaluated and the physical properties of the compressed tablets, namely uniformity of weight, hardness, friability, and disintegration time, assay of content and dissolution rate determined. The granules had good flow properties as evidenced by their Hausner ratio, angle of repose and Carr’s index values. The gum was successfully employed as a binding agent in Paracetamol tablet formulations with different concentrations of Shea gum and acacia gum at the same concentration. The study showed that Shea gum can be successfully employed as a binder at concentrations between 5% w/v and 20% w/v and the binding effect was found to be comparable to the binding effect of the same concentration of acacia.The suspending property of the gum was investigated by assessing parameters such as rate of sedimentation, apparent viscosity and ease of redispersibility of paracetamol suspensions prepared with concentrations of 1% w/v to 4% w/v shea gum and compared with those prepared with acacia gum at the same concentration. Suspensions were successfully prepared using the gum, but the sediment showed a tighter packing as the concentration of the gum used was increased. Shea gum proved more efficient as a suspending agent than acacia gum. The emulsifying property of the gum was also investigated by preparation of emulsions using different classes of oils and employing the wet and dry gum methods of preparation. The ratio of oil to water to gum for the preparation of primary emulsion was determined for the oils. The stability of the emulsions was assessed and an improvement in the stability was attempted using homogenization, a surface active agent, and the addition of a thickening agent. The results obtained demonstrated that emulsions could be prepared with the mineral oil and fixed oil and volatile oil with ease. All the emulsions stabilized by homogenization creamed on the third day, but creaming was reduced by addition of very low concentrations of a thickening agent, xanthan gum at low concentrations of between 0.1% w/v and 0.2% w/v. The addition of a surface active agent (Tween 60) also reduced the creaming of the emulsions at low concentrations of between 0.001% w/v and 0.004% w/v.
- ItemStudies on the Film Coating Potential of Anacardium Occidentale (Cashew Tree) Gum(2012-06-15) Amekyeh, HildaThis research work involved the study of Anacardium occidentale (cashew) gum as a material for pharmaceutical film coating. Both the crude and purified forms of the gum were evaluated for some physicochemical properties. The percentage yield for the purification was appreciable. The gum was found to be acidic and its viscosity significantly increased with increasing concentration and storage time. Both crude and purified gums had acceptable insoluble matter and moisture content. Polymeric films were prepared from homogenous solutions of the purified cashew gum only and mixtures of the cashew gum with either hydroxypropyl methylcellulose (HPMC) or carboxymethyl cellulose (CMC) using the solvent casting method in plastic petri dishes, using different plasticisers. The physical (weight and thickness) and mechanical (folding endurance, tensile strength, percentage elongation, Young’s modulus) properties of these films were determined. Paracetamol tablets were prepared and used as the model drug for the research work. The tablets were film coated with solutions of the cashew gum using different coating times. Quality tests including uniformity of weight, thickness, hardness, friability, disintegration time, assay and dissolution on both the uncoated and film coated tablets were conducted. The results obtained established that propylene glycol is not a suitable plasticiser for cashew gum and that blending cashew gum with hydroxypropyl methylcellulose or carboxymethyl cellulose produced non – uniform and films of poor clarity respectively. Cashew gum on its own produced transparent and smooth, but brittle films. Addition of plasticisers to the gum imparted flexibility to the films. Increasing cashew gum and plasticiser concentrations in the films increased the folding endurance and elongation of the films. Tensile strength was enhanced when gum amount was increased but a decrease in tensile property was observed when plasticiser amount was increased. Young’s modulus decreased when both cashew gum and plasticiser amounts were increased. Both uncoated and coated tablets passed all the quality tests. Application of the gum as a film coat to paracetamol tablets enhanced the mechanical strength of the tablets, in terms of friability and hardness. The rate of drug release was higher for the uncoated paracetamol tablets than for the film coated ones. The percentage drug release in phosphate buffer (pH-6.8) was higher than in 0.1M HCl dissolution medium. Film coating of core paracetamol tablets did not significantly impact on the immediate-release nature of the tablets. The mechanism of drug release from the tablets was found to be by diffusion. Cashew gum can therefore be used successfully as a film coating agent for immediate-release tablets.