Search Results (33)

(1) Background: Spatial energy expenditure patterns, driven by physical activity, particularly among females, remain underexplored in Ghana. This study, therefore, investigates spatial energy expenditure clustering or dispersion patterns using metabolic equivalents of task (METs) values among Ghanaian females across rural and urban areas. (2) Methods: Using 13,799 data from the 2022 Ghana Demographic and Health Survey, METs values were assigned to self-reported occupation categories as proxies for physical activity. Global and local spatial autocorrelation metrics (Queen contiguity and Moran’s I) were employed to assess spatial clustering or dispersion of METs values across the 16 administrative regions. (3) Results: Rural females reported higher METs (mean = 3.35 ± 1.627) and lower BMI (23.476 ± 3.888) than urban females (METs: mean = 2.42 ± 1.208, BMI: 25.313 ± 4.854). There was a significant but weak global spatial autocorrelation (Moran’s I = 0.003, p-value = 0.001), with stronger clustering observed in rural (Moran’s I = 0.004, p-value = 0.001) than in urban areas (Moran’s I = 0.002, p-value = 0.002). Also, High–High clusters were prevalent in the Northern, Savannah and Northeast regions particularly due to the lingering labour-intensive occupations as compared to Low–Low clusters in the Eastern and Greater Accra regions where jobs are often desk-based and sedentary. (4) Conclusions: Given the revealed geographic heterogeneity (High–High and Low–Low clustering) of female energy expenditure in Ghana, there is a need for regionally tailored health policies targeting physical inactivity and its associated risks. Full article

The use of family planning (FP) methods significantly contributes to improved outcomes for mothers and their offspring. However, the use of FP remains low, particularly in low- and middle-income countries. A cluster randomized controlled clinical trial was implemented in Ghana, comparing group antenatal care (ANC) with routine care. The group ANC intervention included eight meetings where the seventh group meeting incorporated information and discussion regarding methods of FP. Data collection occurred at five time points: baseline (T0), 34 weeks’ gestation (T1), 6–12 weeks post birth (T2), 5–8 months post birth, and 11–14 months post birth (T4). At T1, there was a significantly greater increase in the knowledge of FP methods as well as the intention to use FP after the birth among the intervention group. The uptake of FP was significantly higher in the intervention group for all post-birth timepoints except for T4 where the control group had significantly higher rates. The reasons for the diminishing effect are unclear. An increasing uptake of FP methods requires a multifaceted approach that includes increasing accessibility, knowledge, and acceptability as well as addressing societal and cultural norms. Full article

Strengthening routine immunization systems to successfully deliver childhood vaccines during the second year of life (2YL) is critical for vaccine-preventable disease control. In Ghana, the 18-month visit provides opportunities to deliver the second dose of the measles–rubella vaccine (MR2) and for healthcare workers to assess for and provide children with any missed vaccine doses. In 2016, the Ghana Health Service (GHS) revised its national immunization policies to include guidelines for catch-up vaccinations. This study assessed the change in the timely receipt of vaccinations per Ghana’s Expanded Program on Immunizations (EPI) schedule, an important indicator of service quality, following the introduction of the catch-up policy and implementation of a multifaceted intervention package. Vaccination coverage was assessed from household surveys conducted in the Greater Accra, Northern, and Volta regions for 392 and 931 children aged 24–35 months with documented immunization history in 2016 and 2020, respectively. Age at receipt of childhood vaccines was compared to the recommended age, as per the EPI schedule. Cumulative days under-vaccinated during the first 24 months of life for each recommended dose were assessed. Multivariable Cox regression was used to assess the associations between child and caregiver characteristics and time to MR2 vaccination. From 2016 to 2020, the proportion of children receiving all recommended doses on schedule generally improved, the duration of under-vaccination was shortened for most doses, and higher coverage rates were achieved at earlier ages for the MR series. More timely infant doses and caregiver awareness of the 2YL visit were positively associated with MR2 vaccination. Fostering a well-supported cadre of vaccinators, building community demand for 2YL vaccination, sustaining service utilization through strengthened defaulter tracking and caregiver-reminder systems, and creating a favorable policy environment that promotes vaccination over the life course are critical to improving the timeliness of childhood vaccinations. Full article

Background: Understanding the drivers of coverage for vaccines offered in the second year of life (2YL) is a critical focus area for Ghana’s life course approach to vaccination. This study characterizes the predictors of vaccine receipt for 2YL vaccines—meningococcal serogroup A conjugate vaccine (MACV) and the second dose of measles-containing vaccine (MCV2)—in Ghana. Methods: 1522 children aged 18–35 months were randomly sampled through household surveys in the Greater Accra Region (GAR), Northern Region (NR), and Volta Region (VR). The association between predictors and vaccination status was modeled using logistic regression with backwards elimination procedures. Predictors included child, caregiver, and household characteristics. Results: Coverage was high for infant vaccines (>85%) but lower for 2YL vaccines (ranging from 60.2% for MACV in GAR to 82.8% for MCV2 in VR). Predictors of vaccination status varied by region. Generally, older, first-born children, those living in rural settlements and those who received their recommended infant vaccines by their first birthday were the most likely to have received 2YL vaccines. Uptake was higher among those with older mothers and children whose caregivers were aware of the vaccination schedule. Conclusions: Improving infant immunization uptake through increased community awareness and targeted strategies, such as parental reminders about vaccination visits, may improve 2YL vaccination coverage. Full article

The global climate has changed, and there are concerns about the effects on both humans and the environment, necessitating more research for improved adaptation. In this study, we analyzed extreme temperature and rainfall events and projected future climate change scenarios for the coastal Savannah agroecological zone (CSAZ) of Ghana. We utilized the ETCCDI, the RClimDex software (version 1.0), the Mann–Kendall test, Sen’s slope estimator, and standardized anomalies to analyze homogeneity, trends, magnitude, and seasonal variations in temperature (T_max and T_min) and rainfall datasets for the zone. The SDSM was also used to downscale future climate change scenarios based on the CanESM2 (RCP 2.6, 4.5, and 8.5 scenarios) and HadCM3 (A2 and B2 scenarios) models for the zone. Model performance was evaluated using statistical methods such as R², RMSE, and PBIAS. Results revealed more changepoints in T_min than in T_max and rainfall. Results again showed that the CSAZ has warmed over the last four decades. The SU25, TXn, and TN90p have increased significantly in the zone, and the opposite is the case for the TN10p and DTR. Spatially varied trends were observed for the TXx, TNx, TNn, TX10p, TX90p, and the CSDI across the zone. The decrease in RX1day, RX5day, SDII, R10, R95p, and R99p was significant in most parts of the central region compared to the Greater Accra and Volta regions, while the CDD significantly decreased in the latter two regions than in the former. The trends in CWD and PRCPTOT were insignificant throughout the zone. The overall performance of both models during calibration and validation was good and ranged from 58–99%, 0.01–1.02 °C, and 0.42–11.79 °C for R², RMSE, and PBIAS, respectively. T_max is expected to be the highest (1.6 °C) and lowest (−1.6 °C) across the three regions, as well as the highest (1.5 °C) and lowest (−1.6 °C) for the entire zone, according to both models. T_min is projected to be the highest (1.4 °C) and lowest (−2.1 °C) across the three regions, as well as the highest (1.4 °C) and lowest (−2.3 °C) for the entire zone. The greatest (1.6 °C) change in mean annual T_max is expected to occur in the 2080s under RCP8.5, while that of the T_min (3.2 °C) is expected to occur in the 2050s under the same scenario. Monthly rainfall is expected to change between −98.4 and 247.7% across the three regions and −29.0 and 148.0% for the entire zone under all scenarios. The lowest (0.8%) and highest (79%) changes in mean annual rainfall are expected to occur in the 2030s and 2080s. The findings of this study could be helpful for the development of appropriate adaptation plans to safeguard the livelihoods of people in the zone. Full article

Drought and wetness events have become common due to global warming, warranting the need for continuous analysis and monitoring of drought and wet events to safeguard people’s livelihoods. In this study, the Standardized Precipitation Evapotranspiration Index (SPEI) was utilized to analyze the spatiotemporal characteristics of drought and wetness events in the coastal Savannah agroecological zone from 1981 to 2021. Climate data from 14 locations across the zone were used to characterize drought and wetness events at the 3 and 12 month timescales. Except for September 1995 and November 2002, when changepoints occurred, the results revealed the homogeneous nature of temperature and rainfall in the zone. More drought events were observed in the dry and minor seasons, while the wet season had more wetness events under both the SPEI-3 and SPEI-12 timescales. The results also showed that, while moderate-to-severe drought events were common for most years, extreme drought events were more typical in the 1980s and 1990s than in the 2000s under both the SPEI-3 and SPEI-12. Furthermore, the 2000s saw more moderate-to-severe wetness events than the 1980s and 1990s, while the greatest number of extreme wetness events occurred in 1987, followed by 1997 and 2021 under the SPEI-3, and a few moderate-to-extreme wetness events occurred in 1987, 1991, 1997–1998, 2012–2013, 2018, and 2020–2021 under the SPEI-12. Under the SPEI-12, only extreme drought events showed a significant positive trend with a small magnitude of change. On the spatial scale, drought and wetness events occurred more frequently in the Central and Volta regions than in the Greater Accra region; however, the intensity and duration of the events were stronger and lasted longer in the Greater Accra and Central regions than in the Volta region. The regular monitoring of drought and wetness events is required to protect the livelihoods of people in the zone. Full article

With safely managed water accessible to only 19% of the population in Ghana, the majority of its residents are at risk of drinking contaminated water. Furthermore, this water could be a potential vehicle for the transmission of antimicrobial-resistant bacteria. This study assessed the presence of bacteria and the antibiotic resistance profile of Escherichia coli and Pseudomonas aeruginosa in drinking-water sources using membrane filtration and Kirby–Bauer disc diffusion methods. A total of 524 water samples were analyzed for total coliforms, total heterotrophic bacteria, E. coli and P. aeruginosa. Samples included sachets, bottled water, tap water, borehole and well water. Most of the sachet and bottled water samples were within the limits of Ghana’s standards for safe drinking water for the parameters tested. Over 50% of tap and borehole water was also free of E. coli and P. aeruginosa. Overall, of 115 E. coli isolates from tap and ground water samples, most were resistant to cefuroxime (88.7%), trimethoprim–sulfamethoxazole (62.6%) and amoxicillin–clavulanate (52.2%). P. aeruginosa isolates were most resistant to aztreonam (48%). Multidrug resistance was predominantly seen among E. coli isolates (58%). Evidence from this study calls for routine antimicrobial resistance surveillance in drinking water across the country and additional treatment of water sources at household levels. Full article

Malaria remains a serious public health challenge in Ghana including the Greater Accra Region. This study aimed to quantify the spatial, temporal and spatio-temporal patterns of malaria in the Greater Accra Region to inform targeted allocation of health resources. Malaria cases data from 2015 to 2019 were obtained from the Ghanaian District Health Information and Management System and aggregated at a district and monthly level. Spatial analysis was conducted using the Global Moran’s I, Getis-Ord Gi*, and local indicators of spatial autocorrelation. Kulldorff’s space–time scan statistics were used to investigate space–time clustering. A negative binomial regression was used to find correlations between climatic factors and sociodemographic characteristics and the incidence of malaria. A total of 1,105,370 malaria cases were reported between 2015 and 2019. Significant seasonal variation was observed, with June and July being the peak months of reported malaria cases. The hotspots districts were Kpone-Katamanso Municipal District, Ashaiman Municipal Districts, Tema Municipal District, and La-Nkwantanang-Madina Municipal District. While La-Nkwantanang-Madina Municipal District was high-high cluster. The Spatio-temporal clusters occurred between February 2015 and July 2017 in the districts of Ningo-Prampram, Shai-Osudoku, Ashaiman Municipal, and Kpone-Katamanso Municipal with a radius of 26.63 km and an relative risk of 4.66 (p < 0.001). Malaria cases were positively associated with monthly rainfall (adjusted odds ratio [AOR] = 1.01; 95% confidence interval [CI] = 1.005, 1.016) and the previous month’s cases (AOR = 1.064; 95% CI 1.062, 1.065) and negatively correlated with minimum temperature (AOR = 0.86, 95% CI = 0.823, 0.899) and population density (AOR = 0.996, 95% CI = 0.994, 0.998). Malaria control and prevention should be strengthened in hotspot districts in the appropriate months to improve program effectiveness. Full article

Nasopharyngeal carriage of aerobic Gram-negative bacilli (GNB) may precede the development of invasive respiratory infections. We assessed the prevalence of nasopharyngeal carriage of aerobic GNB and their antimicrobial resistance patterns among healthy under-five children attending seven selected day-care centres in the Accra metropolis of the Greater Accra region of Ghana from September to December 2016. This cross-sectional study analysed a total of 410 frozen nasopharyngeal samples for GNB and antimicrobial drug resistance. The GNB prevalence was 13.9% (95% CI: 10.8–17.6%). The most common GNB were Escherichia coli (26.3%), Klebsiella pneumoniae (24.6%), and Enterobacter cloacae (17.5%). Resistance was most frequent for cefuroxime (73.7%), ampicillin (64.9%), and amoxicillin/clavulanic acid (59.6%). The organisms were least resistant to gentamicin (7.0%), amikacin (8.8%), and meropenem (8.8%). Multidrug resistance (MDR, being resistant to ≥3 classes of antibiotics) was observed in 66.7% (95% CI: 53.3–77.8%). Extended-spectrum beta-lactamase (ESBL)-producing bacteria constituted 17.5% (95% CI: 9.5–29.9%), AmpC-producing bacteria constituted 42.1% (95% CI: 29.8–55.5%), and carbapenemase-producing bacteria constituted 10.5% (95% CI: 4.7–21.8%) of isolates. The high levels of MDR are of great concern. These findings are useful in informing the choice of antibiotics in empiric treatment of GNB infections and call for improved infection control in day-care centres to prevent further transmission. Full article

There is little published information on antimicrobial resistance (AMR) in animals in Ghana. We determined the prevalence and factors associated with AMR, multi-drug resistance (MDR-resistance to ≥3 antimicrobial classes) and colistin resistance in Enterobacteriaceae in healthy pigs in Accra, Ghana. Rectal swabs obtained from the pigs on 20 farms from January to March 2022, were examined for Escherichia coli, Enterobacter spp. and Klebsiella pneumoniae. AMR was determined using standard microbiological techniques and the mcr-1 gene detected through molecular analysis. Enterobacteriaceae were isolated from 197 of 200 pigs: these comprised 195 E. coli isolates, 38 Enterobacter spp. and 3 K. pneumoniae, either singly or combined. Over 60% of E. coli were resistant to tetracycline, with 27% and 34% being resistant to amoxicillin/clavulanic acid and ampicillin, respectively; 23% of E. coli and 5% of Enterobacter spp. exhibited MDR phenotypes. Phenotypic colistin resistance was found in 8% of E. coli and Enterobacter spp., with the mcr-1 gene detected in half. Our study findings should be incorporated into on-going AMR, MDR and colistin resistance surveillance programs in Ghana. We further advocate for tailored-specific education for pig farmers on animal antimicrobial use and for strengthened regulatory policy on antimicrobial usage and monitoring in the animal production industry. Full article

Domestic waste collectors face major public health hazards that result in injuries and morbidity globally. This study explored domestic waste collectors’ perceptions of occupational safety and self-reported health issues in a city in Ghana using a phenomenological qualitative research design. In-depth interviews and focus group discussions were held with 64 domestic waste collectors from two waste companies. The transcribed data were imported into NVivo 11.0 software (QSR International, Burlington, MA, USA) for coding, and a content analysis was applied to analyze all the transcribed data using the processes of induction and deduction. The consensual views from the domestic waste collectors showed the waste-company employers’ non-interest in the domestic waste collectors’ occupational safety and health. Poor communication from employers to domestic waste collectors and huge workloads were identified as the causes of the poor implementation of occupational safety practices, which exposed the domestic waste collectors to occupational health hazards. The domestic waste collectors reported that they suffered from occupational injuries, psychosocial disorders, work-related stress, and frequent burnout. The domestic waste collectors adopted coping strategies, such as self-medication, to deal with these occupational hazards, since most of them were not covered by guaranteed health insurance. In addition, the study revealed the non-compliance and non-enforcement of occupational health and safety policies by the employers to guide health and safety training and practices among the domestic waste collectors. In conclusion, the findings suggest that DWCs are exposed to occupational safety and health hazards in their work. Waste-company employers should extend welfare benefits to DWCs, such as health insurance and social security benefits, to ensure their security, health, and well-being. The findings could inform the design of intervention programs and policies to guide training and practices for domestic waste collectors. Full article

Biodiversity in all its forms has come under threat. The rate of biodiversity loss has attracted global attention, and most governments are trying to put measures into place to reduce the rate of loss. One way to ensure that people are conscious of biodiversity conservation is through education. However, studies on creating awareness for biodiversity conservation have received less attention in the literature. To address this knowledge gap, this study used questionnaires to investigate the role of education in biodiversity conservation in the Greater Accra Region of Ghana. The study found that environmental education, particularly an awareness of biodiversity conservation, is critical for conserving biodiversity. However, people’s knowledge of biodiversity conservation is too weak or inadequate to motivate them to incorporate biodiversity conservation practices into their daily activities. Furthermore, understanding the importance of biodiversity conservation comes with an increase in age. Increasing education on biodiversity conservation at an early age can help people become more aware of biodiversity conservation as they age, and they can incorporate it into their daily activities to reduce biodiversity loss. The study calls for a revision of the environmental education syllabus at various levels, particularly the basic and SHS levels, including more practical topics to help people change their attitudes and perceptions and incorporate biodiversity into their daily activities. Full article

This article uses a modified model of the theory of planned behaviour to assess salient beliefs of household heads towards the separation of municipal solid waste at its source in the Greater Accra Region of Ghana. Structural equation modelling was used to analyse the responses of 598 household heads to a questionnaire in a cross-sectional design. Whilst the default model produced an acceptable fit to the data and explained 37% of the variance in households’ intention to separate waste at its source, the modified model with moral norms as an additional construct fitted the data excellently, explaining 52% of the variance in intention. Moral norms and perceived behavioural control were the predominant latent constructs to influence intentions. Control beliefs related to the availability of waste receptacles, provision of regular waste collection services, and access to knowledge of the separation process had the greatest tendency to facilitate households’ intentions. Pro-environmental interventions designed in a participatory manner to promote moral correctness, responsibility, respect for the environment, and positive affect may empower households to separate waste at its source. This research contributes to the development of a municipal solid waste strategy in the region, and may further support research in waste diversion and the circular economy in other jurisdictions. Full article

This study examines the effect of the COVID-19 pandemic on hotel employees in the Greater Accra Region of Ghana using the conservation of resource and human relations theories to ascertain the level of impact. Data was collected from 511 hotel employees from 58 hotels using questionnaires. The employees were randomly sampled. Stepwise Regression in Statistical Package for Social Sciences version 16 model was used to run the analysis. Nine independent variables were included in a stepwise regression model. Six came out as significant and explained 51.6% of the variation in the percentage of their salary that staff received during the current COVID-19 pandemic. The remaining 48.4% was explained by other factors such as the years of service and whether the facility shut down during the lockdown. It was further identified that about 80% of the respondents had their salaries reduced, and that work schedules and working hours were altered, particularly during the lockdown and closure of the country’s borders. It is recommended that hotels should network, be more customer-oriented, be health- and safety-focused, frequently update their communication channels, and make digitalisation and human resource development a priority as measures to help the industry in its recovery process. Full article

Tailored interventions in the tomato sector require current information on production and marketing systems along with the constraints faced by the stakeholders. We conducted this study to understand the current production practices, stakeholders’ varietal preferences, tomato market trends, and challenges along the crop’s value chains. A multistage sampling method coupled with a random walk was used to identify survey locations and identify 180 respondents across seven regions in Ghana. The study showed that tomato was predominantly produced by male (81%) and literate farmers (84%). Tomato farmers were smallholder farmers generally cultivating less than five acres. Tomato was mainly cultivated under rainfed conditions. Farmers used both bought seeds and their own saved seeds for production. Farmers in Bono, Greater Accra, and the Upper East region largely cultivated improved tomato varieties, while farmers in the Bono East region cultivated local varieties. Across the regions, being a male and having access to irrigation facilities increased the probability of using improved varieties by 19% and 51%, respectively. The most important farmer and market preference criteria included high yield, medium to large fruit size and rounded fruit shape, red color, time to maturity and disease resistance. The major production challenges of tomato production included diseases, pests, and poor access to water for irrigation. The average yield of tomato varied from 6902.26 kg/ha in the Bono Region to 16,213.98 kg/ha in Bono East. Tomato was exclusively produced for fresh market. The major marketing challenges were low producer prices, low demand for produce, and competition from other farmers. This study provides key information to improve tomato value chains and guide the introduction or breeding of improved tomato varieties. Full article