Strategies for high rise building sanitary drainage systems design in Ghanaian building industry

The Greater Accra Region (GAR) of Ghana records 2000 stillbirths annually and 40% of them occur intrapartum. An understanding of the contributing factors will facilitate the development of preventive strategies to reduce the huge numbers of intrapartum stillbirths. This study identified determinants of intrapartum stillbirths in GAR. A retrospective 1:2 unmatched case–control study was conducted in six public hospitals in the Greater Accra Region of Ghana. A multivariable binary logistic regression model was used to quantify the effect of exposures on intrapartum stillbirth. The area under the receiver operating characteristics curve and the Brier scores were used to screen potential risk factors and assess the predictive performance of the regression models. The following maternal factors increased the odds of intrapartum stillbirths: pregnancy-induced hypertension (PIH) [adjusted Odds Ratio; aOR = 3.72, 95% CI:1.71–8.10, p < 0.001]; antepartum haemorrhage (APH) [aOR = 3.28, 95% CI: 1.33–8.10, p < 0.05] and premature rupture of membranes (PROM) [aOR = 3.36, 95% CI: 1.20–9.40, p < 0.05]. Improved management of PIH, APH, PROM, and preterm delivery will reduce intrapartum stillbirth. Hospitals should improve on the quality of monitoring women during labor. Auditing of intrapartum stillbirths should be mandatory for all hospitals and Ghana Health Service should include fetal autopsy in stillbirth auditing to identify other causes of fetal deaths. Interventions to reduce intrapartum stillbirth must combine maternal, fetal and service delivery factors to make them effective.

Myiasis is the infestation of tissues of live vertebrate animals and humans with dipterous larvae. In sub-Saharan Africa, Cordylobia anthropohaga and Cordylobia rodhaini are known to be responsible for cutaneous myiasis in animals and humans. Human cases of myiasis, purportedly acquired in Ghana but diagnosed in other countries, have been reported; however, published data on its occurrence in animals in Ghana is unavailable. This study assessed the prevalence of canine myiasis among owned dogs in the Greater Accra region (GAR) of Ghana. A cross-sectional study was conducted in the Greater Accra region of Ghana, selected for being the region with the highest estimated population density of owned dogs. Physical examination and demographic characteristics of the study dogs were assessed. Management of the dogs was assessed through a questionnaire administered to the dog owners. A total of 392 owned dogs were sampled. Twenty-nine (7.4%) had cutaneous myiasis caused by C. rodhaini. In addition, one (0.2%) of the dogs had intestinal myiasis, with Dermatobia hominis as the offending larvae. Among the breeds of dogs with myiasis, the mongrel was most affected, with 24 (82.8%) out of the 29 cases. The mongrels, majority of which (24; 82.8%) were males, were left to roam freely in the community. Results from this study demonstrate that C. rodhaini and D. hominis are important causes of myiasis in owned dogs in the GAR of Ghana. Dogs could play a role in the spread of myiasis to humans, with its attendant public health implications.

Fast food has been extensively debated but most studies have focused on one or two of its characteristics. Using the cuisine concept, we propose a more comprehensive approach to the study of fast food characteristics and availability, while taking cultural context into account. The objectives of this paper are to explore the usefulness of the cuisine concept and to provide some insight into fast food characteristics and its availability in the Greater Accra Region (GAR) of Ghana. We used quantitative and qualitative approaches to obtaine data from restaurateurs and consumers in GAR. The study showed that fast food in GAR comprised “globally recognized popular fast foods” including French fries, pizzas, and fried rice, and some traditional Ghanaian foods such as jollof rice, banku with tilapia, and kelewele. The foods, usually hot and spicy, were mainly obtained from restaurants and check-check vendors, eaten with cutlery, fingers or both, together with a drink, and mostly in the company of other people. In total, 68% of restaurants in GAR were fast food restaurants. The cuisine concept enabled us to explore more fast food characteristics than what were done in previous studies. The availability of fast foods signals the need for more research to improve our understanding of its contribution to food security and its link with health, culture and environment. We encourage researchers to explore the cuisine concept and identify new significant research questions for advancing the field of food studies.

Prevalence of gastrointestinal helminths and management practices for dogs in the Greater Accra region of Ghana

Due to calls for more sustainable tourism practices, environmental management, which was the preserve of the smokestack industries, has engaged managers of most hotels around the globe. The literature is replete with environmental management practices and initiatives by hotels in North America, Europe and Asia and therefore not much is known about environmental management in hotels in a developing country like Ghana. This article therefore explores the environmental management and sustainable tourism practices in hotels in Ghana based on a survey of 52 managers of various categories of hotels in the Greater Accra Region of Ghana.

Periodontitis is a major public health problem affecting many adults, with considerable variation in its prevalence and severity worldwide. There is little data on its prevalence or associated risk factors in Ghana making development of evidence based preventive programs challenging. This study assessed the prevalence, severity, extent, and associated risk factors of periodontitis in an adult Ghanaian population. A population based cross-sectional study involving adults aged ≥25 years in the Greater Accra Region (GAR) of Ghana. A random stratified two-stage sampling method was used to select participants from rural and urban communities. Data on sociodemographic and risk factors were collected using a semi-structured questionnaire. A full-mouth periodontal examination was performed to diagnose and describe the severity of periodontitis following the CDC-AAP case definition. A total of 729 participants were included in the study, with a mean age of 43.9±14.6 years and 61% being female. Majority (84.8%) presented with gingivitis, 46.7% had periodontitis with 41.8% having both, and 13.9% had severe periodontitis. The mean clinical attachment loss (AL) was 1.36 ± 0.67mm and 1.41 ± 0.57mm for probing depth (PD). Factors associated with periodontitis included, increasing age, smoking, and alcohol use; being Muslim provided lower odds of disease. Older people, former smoking, being underweight and not having health insurance were associated with severe periodontitis. This study shows a high burden of periodontitis with comparatively more severe disease. Existing sociodemographic disparities in disease burden highlights the need of developing targeted population based preventive programs.

Genetic Modification (GM) is a rapidly growing technology that can improve productivity and profitability for producers. The study assessed consumer acceptance of GM foods in the Greater Accra Region of Ghana. The study is based on a survey conducted in three districts of the Greater Accra Region namely, Accra Metropolitan Assembly (AMA), Ga East (GE) and Tema Metropolitan Assembly (TMA) using purposive sampling method. A qualitative choice (Logit) model was used to estimate the effect of various factors on consumer acceptance of GM foods. The results obtained showed that, about 90% of the respondents had heard or read something about GM foods indicating a high level awareness among respondents’ in the Greater Accra Region. The results also show that 85% of the respondents were willing to accept GM foods. From the logit model, consumers with age groups 31-40 and above 50 years, were more likely to accept GM foods in the study area where as male respondents were less likely to accept GMFs. In addition, respondents with secondary and tertiary levels of education were likely to accept GM foods. Household size 1 to 5, reading product labels as well as understanding of science and technology were also significant variables in explaining consumer acceptance of GM foods in the Greater Accra Region. Obviously awareness and education was shown to be a necessary condition for acceptability of GM foods. The recommendation of this study is to promote effective education about the benefits of GM foods to increase the potential for acceptance.

Objective: To investigate the pattern of eye care utilisation and the knowledge of eye care services and personnel among slum dwellers in the Greater Accra Region of Ghana. Design: Cross-sectional descriptive study. Setting: Structured questionnaire was administered to each participant by trained interviewers using the local language were it is evident that participants cannot communicate in English Language. Subjects: Study subjects originally comprised 700 randomly selected adults from seven randomly selected clusters from Accra Metropolitan Assembly designated slum areas in the Greater Accra Region of Ghana. Results: Responses from the remaining sample of 699 subjects (aged 18 – 80 years) comprising 355 (50.8%) males and 344 (49.2%) females were analysed. Majority had little or no formal education. 38.9% of the respondents have health insurance. 44.1% had no knowledge about eye care while 68.7% did not know any eye care professional. 44.7% of those who have had an eye problem had not presented for an eye examination. Some of the respondents still undertake unorthodox and harmful traditional practices such as using sea water to irrigate the eye and applying breast milk to treat eye infections. Conclusions: From our study, we conclude that there is poor uptake of eye care services and poor knowledge of eye care services and personnel in the Greater Accra Region of Ghana.

BackgroundCholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked.MethodsWe carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission.ResultsUp to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis.ConclusionsThe 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.

Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana. An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine. Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.

PurposeThis study aims to assess the facilities management (FM) strategies used in multi-tenanted purpose-built office buildings (Mt-POBs) in Ghana and the drivers that influence the decision to use such strategies.Design/methodology/approachThis study was conducted via a survey and key informant interviews. The survey was conducted using a questionnaire targeted at 65 multi-tenanted office building owners in the Greater Accra region. The data from the survey revealed the views of building owners on FM strategy and the extent to which 20 facility management decision drivers influenced their decisions to use a particular strategy and the responses were descriptively analysed. The key informant interviews were conducted among six leaders of the property owners’ association who use in-house FM to further understand their perspectives and decisions on using such strategy. The interviews were conducted over telephone using an interview guide and analysed using thematic analysis.FindingsThe results showed that 88% of Mt-POBs in Ghana are managed in-house. The results also showed that the decision to use the in-house strategy was driven by the innovative, strategic and cost-saving advantages associated with the in-house strategy.Originality/valueThis study shows the factors that drive the decision of multi-tenanted office building owners in Ghana to use the in-house strategy. The findings of this study will be useful for prospective owners of office buildings in Ghana.

The Greater Accra Region is the smallest of the 16 administrative regions in Ghana. It is highly populated and characterized by tropical climatic conditions. Although efforts towards malaria control in Ghana have had positive impacts, malaria remains in the top five diseases reported at healthcare facilities within the Greater Accra Region. To further accelerate progress, analysis of regionally generated data is needed to inform control and management measures at this level. This study aimed to examine the climatic drivers of malaria transmission in the Greater Accra Region and identify inter-district variation in malaria burden. Monthly malaria cases for the Greater Accra Region were obtained from the Ghanaian District Health Information and Management System. Malaria cases were decomposed using seasonal-trend decomposition, based on locally weighted regression to analyze seasonality. A negative binomial regression model with a conditional autoregressive prior structure was used to quantify associations between climatic variables and malaria risk and spatial dependence. Posterior parameters were estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling. A total of 1,105,370 malaria cases were recorded in the region from 2015 to 2019. The overall malaria incidence for the region was approximately 47 per 1000 population. Malaria transmission was highly seasonal with an irregular inter-annual pattern. Monthly malaria case incidence was found to decrease by 2.3% (95% credible interval: 0.7–4.2%) for each 1 °C increase in monthly minimum temperature. Only five districts located in the south-central part of the region had a malaria incidence rate lower than the regional average at >95% probability level. The distribution of malaria cases was heterogeneous, seasonal, and significantly associated with climatic variables. Targeted malaria control and prevention in high-risk districts at the appropriate time points could result in a significant reduction in malaria transmission in the Greater Accra Region.

The purpose of the study was to find out the predominant forms of Continuous Professional Development for senior high school heads of public Senior High School/ Technical and Vocational Educational and Training (SHS/TVET) in Greater Accra Region of Ghana and their perception of Continuous Professional Development. A descriptive survey method was used, where a questionnaire was administered to the Heads (Headmaster, Assistant Head-Administration and Assistant Head-Academic) of SHS/TVET in the Greater Accra Region. The accessible population for this study comprised all heads of SHS/TVET in the Greater Accra Region. The target population consisted of all heads of public all SHS/TVET in the Greater Accra Region. A census was used to select all heads of public all SHS/TVET in the Greater Accra Region. A self-designed questionnaire with a Cronbach alpha reliability coefficient of 0.85 was used for the data collection. Means and Standard Deviations were used to analyse data for the study. It was found that Conferences, workshops and academic programs are the predominant form CPD undertaken by the heads of public SHS/TVET and that the heads expressed that the performance of the Head is dependent on the perception of professional development. It was therefore recommended that the Ministry of Education to make policies as to enhancing sponsorships continuous Professional Development for senior high school heads in the management of the SHS/TVET.

Estimating yield and income effects of formal credit-based programme among tomato farmers in the Greater Accra Region of Ghana

Background: Questions remain on the quality of malaria and HIV Rapid Diagnostic Test kits (RDTs) stocked and used in health facilities in Ghana. The Food and Drugs Authority (FDA) in Ghana is mandated to regulate RDTs for quality. By this, all RDTs must be registered, and each brand given a unique registration number. This study aimed to assess the quality of malaria and HIV RDTs in health facilities in the Greater Accra Region of Ghana, using FDA standards. Method: Data was obtained using structured questionnaire from 400 facilities in three districts in the Greater Accra region. A multi-stage sampling procedure was used to select the health facilities including retail medicine outlets. Information on the registration status of the RDTs and conditions under which they were stored were gathered. RDTs kept in air conditioned or well-ventilated rooms were considered as being stored under good condition. RDTs, registered by the FDA and appropriately stored were considered to be of good quality. Data was coded, stored, and analyzed using STATA version 15. Results: About 17% of the malaria RDTs stocked in the pharmacies were unregistered, 85.7% in hospitals were registered. Also, 83.3% of HIV RDTs in the Policlinics were registered. Registration status of the RDTs were associated with the districts in which the health facilities were located (p = 0.006). The RDTs were generally stored under good conditions (99.5%). Over forty percent (41.9%) of user practitioners interviewed rated the quality of the malaria RDTs as good and 59.2% rated HIV RDTs as very good. Conclusion: Though there were some unregistered RDTs whose quality cannot be ascertained, the quality of malaria and HIV RDTs in the facilities assessed were rated as good and likely to produce good results for malaria and HIV case detection.